A Systematic Review of Mechanisms Underpinning Psychological Change Following Nature Exposure in an Adolescent Population.

This systematic review aimed to identify mechanisms of psychological change following exposure to nature within an adolescent population. Keyword searches within Scopus, PsychINFO and Web of Science were carried out to include articles published by 14 September 2021. Records were reviewed in line with inclusion criteria: samples with an average age of 24 and under, exposure to nature vs. control using an experimental or quasi-experimental design and outcomes of mental health and psychological status. The review resulted in 27 papers that were assessed for methodological quality and manually searched for mediation analyses. A range of psychological outcomes were identified and grouped into 10 categories: Mood and Affect, Mental Health, Wellbeing, Perceived Restoration, Stress, Energy, Cognitive Functioning, Resilience, Self-Concept and Pro-Social Behaviour. Only one formal mediation analysis was reported, highlighting a mediating role of belonging in increases in resilience. Limitations include the majority use of university student samples and over half of the papers being of low methodological quality. No firm conclusions on key mechanisms in an adolescent population were made due to insufficient evidence of mediating variables. The development of methodologically rigorous experimental studies with the inclusion of statistical pathway modelling is needed to test and specify plausible mechanisms.

Wellbeing and Social Network Characteristics in Rural Communities: Findings from a Cohort in Social Housing in Cornwall, United Kingdom.

The mental wellbeing of those living in resource poor and rural localities is a public health priority. Despite evidence of a link between social networks and mental wellbeing, little is known about this relationship in the context of rural and resource poor environments. The current study uses novel social network methodology to investigate the extent to which social network size and composition is related to mental wellbeing in a social housing community in rural England. Data come from 88 individuals living in social housing in Cornwall. These participants are part of a larger study of 329 social housing households surveyed in 2017 and 2018. Mental wellbeing was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). A series of multivariable linear regression models were used to test associations between social network characteristics and mental wellbeing. Social network size was significantly associated with the SWEMWBS (b = 0.39, p < 0.01), such that individuals with larger networks reported better mental wellbeing, but after controlling for community social cohesion, this effect dissipated. Neither gender composition or talking with network members about health and wellbeing were significantly associated with the SWEMWBS. Findings suggest that both the quantity of social connections and perceptions of community cohesion are moderately associated with mental wellbeing in rural and resource poor localities. As such, efforts to improve mental wellbeing would benefit from targeting multiple aspects of social relationships, rather than focusing solely on increasing the size of individuals' social networks.

Perceived cognitive deficits and depressive symptoms in patients with multiple sclerosis: Perceived stress and sleep quality as mediators.

Multiple Sclerosis (MS), an autoimmune disorder marked by inflammation of the central nervous system, is associated with a myriad of symptoms. Individuals with MS are more likely to experience depressive symptoms, perhaps due to perceived cognitive impairments. Thus, we aimed to explore perceived stress and sleep deficits as potential mediators of the association between perceived cognitive deficits and depressive symptoms. We recruited a sample of 77 MS participants from an outpatient, university-based MS clinic in the United States. Participants ranged in age between 30 and 75 years old (M = 51.12; SD = 9.6), with more females than males (83% female; n = 64). Participants completed the Perceived Deficits Questionnaire, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, and the Center for Epidemiological Studies Depression Scale - Revised. Correlation analyses and mediation analyses were conducted with bootstrapping technique. Statistical analyses revealed that higher levels of perceived cognitive deficits were associated with lower quality of sleep, more perceived stress, and higher levels of depressive symptoms. Additionally, both perceived stress and sleep quality served as a significant mediator in the perceived cognitive impairments and depressive symptoms linkage. Our novel findings demonstrate the importance of underlying mechanisms (e.g., sleep quality and perceived stress) in the conceptualization of MS. Perceived stress and sleep quality are potentially modifiable factors, perhaps serving as a target for future treatment, to buffer risk of MS patients developing depression.

Pathways to sympathies for violent protest and terrorism.

BACKGROUND: Radicalisation is proposed to explain why some individuals begin to support and take part in violent extremism. However, there is little empirical population research to inform prevention, and insufficient attention to the role of psychiatric vulnerabilities. AIMS: To test the impact of depressive symptoms, adverse life events and political engagement on sympathies for violent protest and terrorism (SVPT). METHOD: A cross-sectional survey of a representative sample of Pakistani and Bangladeshi men and women from two English cities. Weighted, multivariable, logistic regression yielded population estimates of association (odds ratio (OR) and 95% confidence intervals) against a binary outcome of SVPT derived from a three-group solution following cluster analysis. RESULTS: Depressive symptoms were associated with a higher risk of SVPT (OR = 2.59, 95% CI 1.59-4.23, P<0.001), but mediated little of the overall effects of life events and political engagement, which were associated with a lower risk of SVPT (death of a close friend: OR = 0.24, 95% CI 0.07-0.74; donating money to a charity: OR = 0.52, 95% CI 0.3-0.9). CONCLUSIONS: Independent of SVPT associations with depressive symptoms, some expressions of social connectedness (measured as life events and political engagement) are associated with a lower risk of SVPT.

The interrelations between spiritual well-being, pain interference and depressive symptoms in patients with multiple sclerosis.

Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.

Association of alexithymia and depression symptom severity in adults aged 50 years and older.

OBJECTIVES: Alexithymia is a characteristic style of thinking and feeling involving deficits in the recognition of emotions. It is associated with depression onset and severity in younger adults, but researchers have not yet examined the association between alexithymia and depression severity in clinically depressed older adults. DESIGN: Cross-sectional. PARTICIPANTS: One hundred thirty-four patients aged 50 years or older with a confirmed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I mood disorder and currently receiving mental health treatment. MEASURES: Alexithymia was measured using the Toronto Alexithymia Scale-20, a 20-item measure with subscales assessing difficulty identifying feelings, difficulty describing feelings (DDF), and externally oriented thinking. Depression symptom severity was measured using the Beck Depression Inventory, Second Edition (BDI-II). RESULTS: Total alexithymia scores were independently related to depressive symptom severity after controlling for demographics, cognitive functioning, and illness burden. DIF and DDF subscale scores were also independently associated with BDI-II scores. CONCLUSION: The association between alexithymia and depression symptom severity could be attributed to difficulties in recognizing and describing negative emotions and resulting delays in seeking mental health treatment. Future research should focus on modifiable risk factors related to difficulties identifying and describing feelings.

Personality traits in women with multiple sclerosis: discrepancy in patient/partner report and disease course.

OBJECTIVE: Patients diagnosed with multiple sclerosis (MS) are believed to undergo personality changes, which could have implications for how they perceive themselves and are perceived by others. We endeavored to examine the extent to which patients' self-perceptions are congruent with how they are perceived by significant others across five trait domains as demarcated by the well known Five-Factor Model (FFM). METHODS: The NEO Five-Factor Inventory (NEOFFI) (Costa and McCrae, 1992) was administered to women with MS (n=70) and their spouses or partners. Pearson correlations and general linear models (GLMs) were employed to test for differences between patient self-reports and partner reports of FFM traits. RESULTS: Correlation analyses revealed good correspondence between patient and partner NEOFFI data in relapsing-remitting MS patients, but not secondary progressive patients. There was no significant correlation among progressive course patients for all NEOFFI domains, except Agreeableness. GLMs revealed significant differences where patients rated themselves higher than their partners rated them in Extraversion and Openness. CONCLUSION: These discrepancies in the way patients and partners view patient personality are probably multidimensional and may have neurological and/or psychological causes. The direction of the discrepancies are consistent with some prior research suggesting MS, which is a disease affecting both the cerebral white and gray matter, may give rise to lowering in self awareness. Conversely, patients may be finding emotional or personal benefits in their response to the disease unbeknownst to partners.

Implementation intentions, perfectionism, and goal progress: perhaps the road to hell is paved with good intentions.

Two studies explored whether perfectionism moderates the impact of implementation intentions on goal progress. Study 1 used an implementation intention manipulation to examine the effects of these plans in interaction with perfectionism on the progress of New Year's resolutions. Study 2 added a repeated implementation intention condition and monitored affect and monthly goal progress. The results of both studies revealed a significant backfire effect of the implementation intentions on goal progress for participants high on a particular dimension of perfectionism (socially prescribed perfectionism). These perfectionists reported doing significantly worse at reaching their personal goals when they were asked to formulate implementation intentions than when they completed a control exercise. There also was evidence that implementation planning aroused negative affect for socially prescribed perfectionists. These results are the first to suggest that implementation planning may be contra-indicated for individuals with self-critical tendencies.